Extra Health Mandates Will Cost Connecticut

But in the past few years, Connecticut legislators have added so many health benefit mandates that the state ranks near the top nationwide in the number of such requirements.

In two years, when federal health reform takes effect, the state must pick up the tab for any mandates it has added above and beyond the generic national guidelines. That could mean a big financial hit in an already cash-strapped climate.

It's time for the legislature to think hard before adding more.

When the Affordable Care Act takes effect in 2014, many families and small businesses — some estimate 120,000 of them — will buy coverage through the state's Health Insurance Exchange. All the plans offered by the exchange must fulfill a basic set of federal requirements, but states may add mandated benefits to the federal list — if they pay for them.

Connecticut has at least five dozen of these extra mandated benefits, ranging from infertility treatment to breast implant removal, from gastric bypass surgery to wigs for chemotherapy patients.

One can sympathize with legislators for saying yes to the groups that asked for these benefits. The arguments put forth by people with breast or prostate cancer, diabetes or children on the autism spectrum are undeniably heartfelt. The legitimate health care needs in Connecticut are many. And as many have argued, the price of each mandate adds just a small amount to the overall cost of coverage.

But add it all up and the financial impact can be significant. The Council for Affordable Health Insurance, an insurance industry group, says state mandates have increased health care costs between 20 and 50 percent nationwide.

A 2009 state law now requires reviews of mandated benefits. That hasn't stopped the legislature from adding 10 coverage mandates in just the past two years, some not required by any other state. Those include prescription eye drops, MRIs for breast cancer screenings, alternative autism spectrum disorder therapies, prostrate cancer treatment and breast cancer screening by thermography.

This could complicate the quest for low-cost insurance for all Connecticut residents.